Summary
Pain in the coccyx is generally rather rare and in most cases is due to an accident, i.e. a fall. In this case the pain often lasts for several days. Micro-traumas can also be caused by heavy strain on the coccyx during long periods of daily sitting activities, thus causing pain.
In some cases, neurological disorders such as a herniated disc or nerve irritation are responsible for the pain. The exact cause can be determined by a thorough anamnesis, clinical examination and imaging procedures. In most cases the therapy consists of a combination of different physiotherapeutic measures, a soft seat pad and drug therapy in the acute phase of the pain.
A local injection of pain-reducing and anti-inflammatory drugs is also possible. In most cases, the pain subsides by itself after a few days. If this is not the case, a doctor should examine the coccyx pain to prevent the pain from becoming chronic or to detect an inflammatory or tumorous disease.
Pain can only be alleviated if therapy is carried out early and in a targeted manner. When examining the coccyx, in addition to the medical history, the direct examination of the bone is particularly important and informative. The coccyx is palpated with the fingers over the rectum and ideally between the index finger and thumb an attempt is made to grasp and move it.
If this examination is pain-inducing, the suspicion of coccyx pain is confirmed. In addition to this, imaging such as an X-ray or computer tomography or, in women, a gynecological examination can provide clues to possible causes of the pain. If a cause for the pain in the coccyx is found, it must be treated specifically.
If there are no indications, they should first be treated with painkillers and cortisone directly at the site of the pain. This can be very protracted due to the persistence of the pain, which can now also be triggered by lighter pain stimuli thanks to the pain memory. Physiotherapy can have a supportive effect.
In the worst case, the coccyx can be surgically removed. A coccyx contusion occurs far more frequently than a fracture of the coccyx. Even if the fracture of the coccyx is missing, both clinical pictures are almost equally painful.
Like the fracture, typical accident situations are kicks or blows to the buttocks. Classic are falls on the buttocks in winter on slippery roads or also with skateboarders and inline skaters in summer.A hernia should always be excluded by an examination through the rectum or an x-ray. The therapy is similar to that of the hernia in terms of pain therapy and protection.
Sitting on a rubber ring will also bring relief to those affected. Even a bruise can, under unfavorable conditions, cause problems for years. The reason for this is also an automatically adopted relieving posture in the first acute and painful phase of the bruise. This relieving posture leads to tension in the muscles, irritation of the muscle and tendon attachments on the coccyx and, last but not least, as with fractures, to the formation of painful myogeloses and trigger points, the treatment of which can be a lengthy process.
